Native American

While smoking rates can vary from tribe to tribe, Native American communities continue the trend of having the highest rates of cigarette smoking in the country. Several CDC surveys found that the current smoking rate for Native Americans and Alaskan Natives is between 31% and 39%.1 The high smoking rate contributes to Wisconsin having the highest Native American lung cancer rate in the nation, and a 50% higher mortality rate for all cancers combined when compared to whites in Wisconsin.2Even though national tobacco cessation programs have had success with other racial/ethnic groups, quitting attempts remain relatively low among Native Americans.1

Pregnant womenNationally, pregnant Native American women have smoked almost double the rate compared to pregnant white women. During the last three months of pregnancy, 26% of Native American women smoke, leading to adverse pregnancy effects.3 While tailored cessation efforts are important for all pregnant women in Wisconsin, the need is especially high for pregnant Native American women.

YouthNationally, Native American high school smoking rates have dropped from 25% in 2013 to 12% in 2015. Although the rates have been decreasing, it is still above the national average of 11%.7 Early initiation of tobacco use can lead to negative effects among youth.

Traditional tobacco (or ceremonial tobacco) holds important cultural and spiritual importance to most Native American tribes and is used for prayer.5 Ceremonial tobacco is most commonly offered by hand rather than being smoked; when ceremonial tobacco is smoked, it is never inhaled. Commercial tobacco contains thousands of chemicals that are carcinogenic, unlike ceremonial tobacco.5 The distinction between traditional and commercial tobacco is important to reflect how American colonization has impacted tobacco use among Native Americans.

The symbolism and traditions of ceremonial tobacco have also been used as marketing strategies for products like Natural American Spirits and tobacco company-sponsored cultural events. These products make commercial tobacco more attractive to Native Americans and contribute to high smoking rates.7